After the Bleed: When and How to Restart Anticoagulants

Описание: Hi. My name is Dan Witt, from the University of Utah, College of Pharmacy, and we're going to be giving you some information about how and when to restart anticoagulants after a major bleeding episode. One thing that's important to remember is that anticoagulants themselves do not cause bleeding, but they certainly exacerbate bleeding from existing sources and so a fundamental thing that we need to remember when addressing this problem is trying to locate and correct any potential causes of bleeding, and that will help us feel a little bit more secure about our decision to resume anticoagulant therapy once that bleeding is corrected.

To sum up, all of these things, the default plan should be when your patient experiences major bleeding on anticoagulant therapy to think about resuming that therapy, using bleed-related factors and other underlying thromboembolic risk factors and comorbidities. You can then make the decision to try to refute that decision to resume anticoagulation therapy, but in most cases, I think the plan should be to resume, and for GI bleeding it seems like 7 to 14 days is optimal, it’s a little less clear with intracranial hemorrhaging and also whether or not to switch to direct oral anticoagulant or to use warfarin therapy needs further information.